We have been well served by infectious disease specialists affiliated to the NIH, major medical schools, and competent medical commentators. Unfortunately, as we approach the November election, political rhetoric and suspicions of undue pressure on both the FDA and the CDC have detracted from public confidence.
Even if one or more of the candidate vaccines becomes available, it is noted that protection will require two successive injections at one-month intervals. The candidate vaccines will also require an ultra-cold storage chain, which does not currently exist. This will create challenges in accomplishing mass vaccination. Perhaps the biggest obstacle will be the disinclination of citizens to receive the vaccine. Currently, only 25 percent of those surveyed intend to be vaccinated when the vaccine becomes available and it remains to be seen what percent of protection will result despite having a measurable antibody response.
The characterization of vaccine development as a "warp speed" endeavor by the November election has created suspicion. The manufacturers of vaccines issued a joint statement on Sept. 8 declaring that they will not apply for approval from the FDA until appropriate testing is completed. On the same day, AstraZeneca suspended a trial in the UK following a single case of an undiagnosed neurological condition in a recipient. The current phase-3 trial of a Covid-19 vaccine with 30,000 participants may not detect a low-incidence of adverse reactions caused by a novel vaccine.
As a nation we should be committed to uniform adoption of precautions, including masking, social distancing, sanitation and hygiene, and avoiding crowds. We cannot legislate against the virus, destroy it by bluster or eliminate it by denial. We must be guided by experienced infectious disease specialists and epidemiologists who are politically neutral and function in accordance with the Hippocratic oath. We must continue a program of structured testing with rapid results to detect both symptomatic and asymptomatic carriers, who should be quarantined, and their contacts traced and evaluated for risk of infection.
Above all, we should be realistic and make sacrifices in order that transmission rates can be minimized and to endure preventive measures in harmony as a united society. Our collective hope is a safe and effective vaccine to stimulate a level of immunity in our population that effectively lowers the level of susceptibility to below the outbreak threshold and subsequently the disease threshold.
It is axiomatic that until we control Covid-19 we will not restore the economy. Attempting a strategy of "opening up" without suppressing Covid-19 will ultimately perpetuate the disease and cause further undesirable effects on our economy and society.
Dr. Joseph J. Giambrone